I, F. J. Lechere, Master of the Belg S.S. Steinmann, do solemnly, sincerely and truly swear that the following List or Manifest, subscribed by me, and now delivered by me to the Collector of the Customs of the Collection District of New York, is a full and perfect list of all the passengers taken on board the said vessel at Antwerp, Belgium from which port said vessel has now arrived; and that on said list is truly designated the age, the sex and the occupation of each of said passengers, the part of the vessel occupied by each during the passage, the country to which each belongs, and also the country of which it is intended by each to become an inhabitant; and that said List or Manifest truly sets forth the number of said passengers who have died on said voyage, and the names and ages of those who died.
Sworn to this Dec 19th 1876

So help me God,
(signed) F. J. Lechere

before me ________________(illegible signature)

List or Manifest of all the Passengers taken on board the Belg S.S. Steinmann whereof F. J. Lechere, is master, from Antwerp, Belgium burthen 1288 tons.

Columns represent: Names, age in years and months, sex, occupation, the country to which they severally belong, the country of which they intend to become inhabitants, part of the vessel occupied by each passenger during the voyage.

1  Jean Verleyen   43   male   merchant   U States   United States   first cabin

National Archives and Records Administration, Film M237, Reel 406, List 1172.